A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy
Introduction. The diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin’s lymphoma (cHL), also referred to as grey zone lymphoma (GZL), is a challenging diagnosis. There are no standardized guidelines; however, ev...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/4121234 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558313315762176 |
|---|---|
| author | Rajiv M. Mallipudi Lance Alquran Vishnu A. Shenoy Lori A. Leslie John A. Conti |
| author_facet | Rajiv M. Mallipudi Lance Alquran Vishnu A. Shenoy Lori A. Leslie John A. Conti |
| author_sort | Rajiv M. Mallipudi |
| collection | DOAJ |
| description | Introduction. The diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin’s lymphoma (cHL), also referred to as grey zone lymphoma (GZL), is a challenging diagnosis. There are no standardized guidelines; however, evidence strongly suggests that DLBCL-based regimens are effective in the treatment of GZL. Brentuximab vedotin (BV) is an anti-CD30 antibody drug conjugate that has established efficacy in relapsed/refractory Hodgkin and some T-cell lymphomas. There is some evidence that BV has a positive response in non-Hodgkin lymphoma (NHL) with a wide range of CD30 expressions—including GZL. Case. We present a case of a patient initially diagnosed with cHL who underwent repeat biopsy which was revealed to be GZL. Based on PET scanning and immunohistochemical studies, she was classified as a stage IIIA CD20+/CD30+ GZL patient. Given her strong CD30 expression, she underwent 6 cycles of R-BV-CHP (rituximab, brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone) chemotherapy and achieved complete response (CR) both clinically and radiographically. Discussion. Given the rarity of GZL, this case illustrates the immense challenges in making the diagnosis, discusses the current treatment options, and suggests that BV may be a viable therapeutic candidate in the treatment of GZL. |
| format | Article |
| id | doaj-art-4bb60d3ab8a9439ea87911f518ad93d0 |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-4bb60d3ab8a9439ea87911f518ad93d02025-02-03T01:32:45ZengWileyCase Reports in Oncological Medicine2090-67062090-67142019-01-01201910.1155/2019/41212344121234A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP ChemotherapyRajiv M. Mallipudi0Lance Alquran1Vishnu A. Shenoy2Lori A. Leslie3John A. Conti4Hackensack Meridian Health Mountainside Medical Center, Department of Internal Medicine, 1 Bay Ave, Montclair, NJ 07042, USAHackensack Meridian Health Mountainside Medical Center, Department of Internal Medicine, 1 Bay Ave, Montclair, NJ 07042, USAUniversity of Delaware, Newark, DE 19716, USAHackensack Meridian Health Hackensack University Medical Center, John Theurer Cancer Center, 92 2nd Street, Hackensack, NJ 07601, USAHackensack Meridian Health Mountainside Medical Center, Department of Internal Medicine, 1 Bay Ave, Montclair, NJ 07042, USAIntroduction. The diagnosis of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin’s lymphoma (cHL), also referred to as grey zone lymphoma (GZL), is a challenging diagnosis. There are no standardized guidelines; however, evidence strongly suggests that DLBCL-based regimens are effective in the treatment of GZL. Brentuximab vedotin (BV) is an anti-CD30 antibody drug conjugate that has established efficacy in relapsed/refractory Hodgkin and some T-cell lymphomas. There is some evidence that BV has a positive response in non-Hodgkin lymphoma (NHL) with a wide range of CD30 expressions—including GZL. Case. We present a case of a patient initially diagnosed with cHL who underwent repeat biopsy which was revealed to be GZL. Based on PET scanning and immunohistochemical studies, she was classified as a stage IIIA CD20+/CD30+ GZL patient. Given her strong CD30 expression, she underwent 6 cycles of R-BV-CHP (rituximab, brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone) chemotherapy and achieved complete response (CR) both clinically and radiographically. Discussion. Given the rarity of GZL, this case illustrates the immense challenges in making the diagnosis, discusses the current treatment options, and suggests that BV may be a viable therapeutic candidate in the treatment of GZL.http://dx.doi.org/10.1155/2019/4121234 |
| spellingShingle | Rajiv M. Mallipudi Lance Alquran Vishnu A. Shenoy Lori A. Leslie John A. Conti A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy Case Reports in Oncological Medicine |
| title | A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy |
| title_full | A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy |
| title_fullStr | A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy |
| title_full_unstemmed | A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy |
| title_short | A Rare Case of Grey Zone Lymphoma Successfully Treated with Brentuximab Vedotin and R-CHP Chemotherapy |
| title_sort | rare case of grey zone lymphoma successfully treated with brentuximab vedotin and r chp chemotherapy |
| url | http://dx.doi.org/10.1155/2019/4121234 |
| work_keys_str_mv | AT rajivmmallipudi ararecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT lancealquran ararecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT vishnuashenoy ararecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT lorialeslie ararecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT johnaconti ararecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT rajivmmallipudi rarecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT lancealquran rarecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT vishnuashenoy rarecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT lorialeslie rarecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy AT johnaconti rarecaseofgreyzonelymphomasuccessfullytreatedwithbrentuximabvedotinandrchpchemotherapy |